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COPYRIGHT DEPOSIT. 



WORKS OF DR. H. B. BASHORE 

PUBLISHED BY 

JOHN WILEY & SONS, Inc. 



Overcrowding and Defective Housing in 
the Rural Districts. 

12mo. 92 pages, 15 full-page half-tones. Cloth, 
$1.00 net. 

Outlines of Practical Sanitation. 

For Students, Physicians, and Sanitarians. 12mo. 
vi + 208 pages, 42 illustrations, many half-tones. 
Cloth, $1.25 net. 

Sanitation of a Country House. 

12mo, vii+102 pages, 16 full-page half-tone illus- 
trations. Cloth, $1.00 net. 

Sanitation of Recreation Camps and Parks. 

12mo, xiii+109 pages, 19 full-page half-tone illus- 
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Published by THE F. A. DAVIS CO. 
1914 Cherry St., Philadelphia, Pa. 

Outlines of Rural Hygiene. 

For Physicians, Students, and Sanitarians. Il- 
lustrated with 20 engravings, mostly original. 
5f x 7| inches. 86 pages. Bound in extra cloth, 
75 cents net. 



Overcrowding and 

Defective Housing 
in the Rural Districts 



Overcrowding and 
Defective Housing 

in the Rural Districts 

BY 

DR. HARVEY B. BASHORE 

Inspector for Pennsylvania Department of Health 

AUTHOR OF 

"The Sanitation of a Country House," "The Sanitation of Recreation 
Camps and Parks," "Outlines of Practical Sanitation" 



FIRST EDITION 
FIRST THOUSAND 



NEW YORK 

JOHN WILEY & SONS, Inc. 

London,,: CHAPMAN & HALL, Limited 
1915 






Copyright, 191 5, by 
HARVEY B. BASHORE 



Publishers Printing Company 
207-217 West Twenty-fifth Street, New York 



APR 21 1915 

©CI.A398466 



DEDICATED TO THE 

MEMORY OF 

FATHER AND MOTHER 



PREFACE 

When we first began to investigate this 
subject it was hard to believe that real 
overcrowding existed in the country dis- 
tricts, but the more the subject was 
studied the more the fact became ap- 
parent. I little imagined that we had 
conditions in our own small towns and 
villages almost as bad as I had seen in the 
great East Side on Manhattan Island. 
Yet why not? Greed for gold is just as 
strong in the country speculator as in the 
city millionaire, and the owner of a few 
lots is going to make the most of them — 
if he has a chance. 

The observations noted in this little 



x Preface 

work were made for the most part in a 
typical rural farming community, inhab- 
ited by native-born Americans. That 
conditions are vastly worse in the great 
mining and manufacturing districts, no 
one can doubt. Many thanks are due to 
Miss Lucy Shellenberger, visiting nurse 
for the Pennsylvania Department of 
Health, for assistance in preparing the 
work, collecting data of the various 
" lung " houses, and reading the MS. 

West Fairview, Pa., February, 1915. 



CONTENTS 

CHAPTER PAGE 

I. Land Overcrowding 13 

II. House Overcrowding 26 

III. Defective Building 51 

IV. Overcrowded and Defective Schools 66 

V. Results 80 



XI 



Overcrowding and Defective 
Housing in the Rural Districts 

CHAPTER I 

LAND OVERCROWDING 

Overcrowding the land with buildings 
is not so very common in the country, yet 
it does occur in many villages and small 
towns, especially in those which are on 
the "boom" from some rapidly increasing 
industry, and much of this overcrowding 
in villages is due to the "row." We can 
readily understand how building in rows 
may be necessary in the great cities, but 
it surely is not necessary in villages and 
small towns: indeed, I have seen the 

"row" far out in the country, where land 

13 



14 Rural Housing 

is almost valueless. These barrack-like 
houses — and I know one small town 
where a certain small row is called the 
barracks — are perhaps satisfactory for 
soldiers, but for raising families they are 
anything but what they should be. At 
first thought you will say there is no over- 
crowding, but if you will think a little 
further, you will see that there is too much 
building — probably we ought to call it 
defective building — on each lot. 

This overcrowding the land with houses 
does not, of course, injure the land nor 
the* houses, but it is likely to injure the 
occupants, for, necessitating lack of air 
and sunshine in some of the rooms of the 
building, it leads to the consequent evil 
of house and room overcrowding, for the 
less air and sunshine a house has, the less 
people it can properly house. There may 
be room overcrowding in the isolated 
house standing in the middle of a ten-acre 



Land Overcrowding 15 

field, but it is more likely to occur when 
the land is crowded with buildings, per- 
mitting the influx of more families caused 
by the apparent greater amount of hous- 
ing space and cheaper rental. 

There is hardly a village street which 
approaches anything like the width of the 
streets in the great cities — yet adjoining 
these narrow village streets as much land 
is covered relatively by buildings as in the 
city; on the other hand, although the 
village houses do not approach the height 
of the city houses the real condition is 
even worse than in the city, for the narrow 
street is frequently lined on both sides by 
low, bushy trees, and the houses, due to 
the lack of height, have such low ceilings 
that there is really less circulation of air 
than in the ordinary city home. 

In Fig. 1 is shown an example of one 
of these village " rows" which has over- 
crowded the land. These lots, only 



1 6 Rural Housing 

seventy-two feet wide, are completely 
covered at one end by a building which is 
divided into six so-called houses: each 
house contains two rooms downstairs and 
two upstairs. The end houses alone of 
such a building can have light and air on 
more than two sides, but, unfortunately, 
these ends are, in the present instance, 
furnished with very small windows, so 
that these end houses are very little bet- 
ter than the intervening ones. These lots 
should contain just about one -half as 
many houses and the increased rental de- 
rived from the better houses would, prob- 
ably, in the end, yield about as much in- 
come from the land as when it was 
overcrowded with the "row." This in- 
sanitary row is situated in a town of less 
than a thousand people, but some years 
ago when a little "boom" struck the 
place, everybody wanted to get rich 
quick, and the owner of these lots found 



Land Overcrowding 19 

that he could rent many small houses 
profitably. 

Of course it is well to remember that by 
proper building many more people can be 
housed on a given lot than by the im- 
proper building characterized by the usual 
village "row." However, to put up 
buildings which would be proper for 
housing many people would necessitate 
more expense than the value of the land 
would justify, consequently it is better to 
have relatively less building and house 
relatively fewer people on the village lot. 

I was once driving in a wild mountain 
valley in Pennsylvania and came upon a 
settlement made up of the houses of the 
workmen of a nearby industry: rather, 
there were no houses; only a long row, 
divided into compartments, called houses 
in the company's books. The conditions 
here were scarcely better than a city 
block, and the inhabitants — pale, sallow, 



20 Rural Housing 

dirty, and unkempt, from living in badly 
ventilated rooms — showed the typical 
countenances of the overcrowded. Yet 
right here there was land in plenty, land 
everywhere that nobody wanted — land 
for ten dollars an acre, and yet defective 
housing conditions crowded the land be- 
cause the company employing these people 
were too penurious and too careless to 
build houses fit for human habitation. 

Another improvement in the money- 
making scheme of overcrowding is to 
build additional houses on the rear end of 
the lot; very frequently the stable being 
changed into a dwelling-house. I knew an 
instance in which this happened in a 
small town: a man bought the stable at 
the end of a certain lot — a ioo-foot lot — 
and fitted it up as a house and lodged 
therein his numerous family. He could 
have gotten an entire lot and house for 
the same cost a mile or so farther away, 



Land Overcrowding 21 

but he preferred the crowding to the 
longer distance from the village centre. 

I know of a case where a corner lot, 109 
feet long and 58 feet wide, was by this 
arrangement so covered with buildings 
that barely 25 per cent of the lot was un- 
occupied; but 25 per cent unoccupied is 
the rule in some of the large cities, yet 
here was a village lot almost imitating the 
plans of the big city. Now, of course, one 
instance of this class of overcrowding 
might not be so bad, but the tendency is 
there, and sooner or later there will be a 
row of houses facing the street and a row in 
the alley. At first, as there is a demand for 
houses, a fairly good class of people may 
occupy them, but as the houses depreciate 
and the demands lessen, a poorer and more 
negligent class move in and the locality 
degenerates into a veritable " slums." 

In Fig. 2 is shown another phase of 
rural overcrowding the land, which I sup- 



22 Rural Housing 

pose does not happen very often, and 
that is an actual rear tenement, — small 
and insignificant the building is, yet nev- 
ertheless it differs only in degree from the 
big city tenement — the fundamental prin- 
ciple is just the same. It probably came 
about through a re-survey of the street 
which left the old house some distance 
back from the pavement: then an addi- 
tional building was put up in the front 
and the old rear building rented as a 
Chinese laundry — almost as bad as some 
of the buildings in the Chinese quarter in 
New York. 

A similar case worth recording is that 
in which an entire corner lot is covered 
with a building, so much so that the toilet 
accommodations are on the street. This 
result was, to be sure, brought about very 
slowly. A bankrupt speculator owned the 
building and lot, and gradually sold off 
the lot to his neighbor; in fact, sold every- 




Fig. 2. — An Actual Rear Tenement in a Small Town. 



Land Overcrowding 25 

thing except the house, and that his 
neighbor didn't want! 

Of course these are all isolated instances 
given only as samples of conditions which 
exist in many places: they serve to show 
it, possibly, at its worst. There are, how- 
ever, few towns and villages which do not 
have some of these defects: they are 
mostly, I think, in the older ones. In the 
newer towns it is less evident. 

How to prevent this condition from 
arising is not so easy save by proper edu- 
cation of the people. The building of 
rows and shacks begins quite often before 
the village is incorporated, while it is still 
the "country," — only with township su- 
pervision which does not amount to much 
as long as a man keeps to his own land and 
pays his taxes. When the straggling houses 
become incorporated into a town, proper 
building rules can be made and enforced, 
but often already the damage is done. 



CHAPTER II 

HOUSE AND ROOM OVERCROWDING 

House or room overcrowding is the 
common housing defect met with in the 
country — sometimes due to the ill-con- 
structed building, poverty, or thoughtless 
landlord, but in many instances due to the 
carelessness and shif tlessness of the people 
themselves. The " house in the row" 
mentioned in Chapter I is very often re- 
sponsible for a great deal of overcrowding; 
but not all rows are overcrowded. I have 
seen instances where small families lived 
in such limited quarters under proper san- 
itary conditions, but this, I think, is the 
exception. The " house in the row" very 
often contains only four rooms, so it is 

26 




Fig. 3. — Seventeen People Once Lived in this "Row" of 
Three Houses. 



House and Room Overcrowding 29 

very evident that when more than three, 
or at the most four, people live in such a 
house, with only small windows front and 
back, there will be overcrowding and with 
it lack of fresh air and sunshine. 

As an illustration of this overcrowding, 
take the row shown in Fig. 3. Supposed 
to be three houses : at one time this build- 
ing contained seventeen people, and as 
there are only four and one-half bed- 
rooms (if there can be such a thing as half 
a room) in the whole row — one and one- 
half in each house — there was evidently a 
vast amount of overcrowding. The gable 
ends in this case have one small window: 
much better, however, than some others, 
which have no windows. Though the end 
houses in such a row are almost as bad as 
the middle one, they are still considered 
by far the best in the row, as is shown by 
the increased rental paid for them. 

Why are such houses, insanitary they 



30 Rural Housing 

surely are, built in our towns and villages? 
Simply because the owner hopes to make 
io or 12 per cent on his investment; and 
many an opulent family lives on the pro- 
ceeds of a "rotten row" that is a disgrace 
to modern sanitary knowledge. These 
people, the proprietors, I mean — gener- 
ally the best people in their respective 
communities, — fail to realize that insan- 
itary dwellings built in sunless rows, even 
on another street, are a menace to their 
own health. 

In the photograph (Fig. 4) is shown an 
example of gross overcrowding in a certain 
old-fashioned country town. Each wing 
of this building is called a home and 
rented to different families, although con- 
sisting of but one room; one of these is 
occupied by a mother and two sons — one 
eighteen years old : all three live and eat 
in this single room, and all three sleep in 
the one bed (Fig. 5). The other house is 



House and Room Overcrowding 35 

occupied by a man, wife, and two children. 
Bad it surely is, yet this house is owned by 
very respectable people who apparently 
fail to recognize the iniquity of renting 
such a house in the manner given. 

The overcrowding mentioned above is 
in a great measure due to environment 
and landlord, the people themselves not 
being responsible for the existing condi- 
tions. On the other hand, there is very 
much overcrowding due wholly to the 
habits and ignorance of the people them- 
selves. For example, a nurse from one of 
the State Dispensaries, in her visiting 
work, came across a certain farmhouse 
where five people were accustomed to 
sleep in one not very large bedroom, 
which had only one small window, and 
even that was nailed shut; one of these 
five had incipient tuberculosis. These 
people were well-to-do farmers living in a 
large twelve-room stone house, and sim- 



36 Rural Housing 

ply crowded into one room for the sake 
of mistaken economy — presumably to 
save coal and wood. The picture of this 
house (Fig. 6) shows it to be a very com- 
fortable and airy building which would be 
entirely suitable for an even larger family 
to live in, under proper sanitary conditions. 
Another form of this overcrowding is 
seen in certain mountain districts of 
Pennsylvania, and I suppose it may be 
very much the same in other States. It 
has been noted in these places that the 
natives do not have the strong, healthy 
build, and a color redolent of health, but 
the thin, pale, and wan features of those 
suffering from the lack of pure air. Yet 
these people live in the purest of God's 
fresh air, in places akin to those in which 
we build our Sanatoria. Why is it? In 
many instances the explanation seems to 
be dependent on the personal habits of 
these mountaineers, who, on the advent 



House and Room Overcrowding 39 

of winter, "hole up," a good deal like 
certain animals. They lay in a supply of 
wood, but as wood is becoming scarce 
and they are generally lazy and shiftless, 
the supply is not over-abundant, so they 
economize space and heat, and have fire 
only in the cook-stove in the kitchen. 
Windows and unnecessary doors are nailed 
shut, and here around the stove the family 
spend most of the winter, eat and sleep in 
one, or at the most two, rooms: and the 
result? The faces you see here in these 
mountain homes remind you of the faces 
you see in the densely crowded, insanitary 
tenements of the cities. The complete 
outdoor life of summer is barely able to 
combat the bad air and lack of air during 
the winter months, and a chronic con- 
dition of lowered vitality results. 

In the photograph (Fig. 7) is shown one 
of these mountain homes — a typical one. 
The bedroom of this house (Fig. 8), 



40 Rural Housing 

which is the loft with a floor surface fifteen 
feet square, is habitually used by eight 
people. Three sleep in one bed, two in 
another, two more in still another, and the 
mother, who is tubercular, sleeps on the 
cot in the corner. One would hardly be- 
lieve it possible that such overcrowding 
exists, yet there are many cases like this 
among these mountain people. When I 
remonstrated with the owner, who is well 
known to me, about his insanitary living, 
he admitted that conditions were bad and 
that he had hoped to build an addition to 
his house, but he was short of funds. I 
knew he was telling the truth, and as I 
was not anxious to help him negotiate a 
loan, I found it profitable to change the 
subject; loaning money to such does not 
overcome the defect, or if it did, it would 
certainly be temporary. 

A similar example of this overcrowding 
in a mountain home is shown in the pho- 




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o 



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Oh £ 



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U O 



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P 

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House and Room Overcrowding 45 

tograph (Fig. 9) ; this small shack — one 
could hardly call it a house — contains 
seven people. The building is composed 
of four rooms — kitchen, sitting-room, and 
two bedrooms: one of which is used by 
four people and the other by three. The 
rooms are so diminutive and the windows 
so small that, although these people live 
right on the foothills of a wild mountain 
country, they are living under very badly 
overcrowded conditions and are paying 
the penalty — tuberculosis. 

A common phase of overcrowding in 
the country, just as in the city, is the 
" lodger evil," especially in some of those 
districts which are rapidly developing. I 
know of a certain family in a certain small 
town — a typical case — in which this con- 
dition exists. The family of five adults 
are living in a six-room house and take 
one boarder. They are frugal and indus- 
trious Americans, and are trying to pay 



46 Rural Housing 

for their small home; and they are doing 
it, but at the high price of overcrowding; 
for one daughter has died of tuberculous 
meningitis and another at present has the 
appearance of developing the pulmonary 
form of the dread disease. 

The worst case of overcrowding, how- 
ever, that I have ever seen appeared one 
day last summer when I prepared to ad- 
minister immunizing doses of antitoxin to 
an Italian family during an epidemic of 
diphtheria: thirteen children lined up to 
take their "medicine"; in addition, there 
were six adults, making nineteen human 
beings living in one house, and this house 
containing only six rooms. Where these 
people slept was almost a mystery, for 
there were but three beds in the house. 
They simply stretched out on the floor; 
and their pale and sallow faces told the 
cost — the great cost — of overcrowding. 
You might thiftk this was a Hester Street 




Fig. 9. — Seven People Live in this Four-Room Shack, Over- 
crowded, When There are Acres Unoccupied. 



House and Room Overcrowding 49 

tenement, but it happened to be a farm- 
house, situated in one of the most beauti- 
ful valleys of Southern Pennsylvania, far 
from the smoke and din of cities. The old 
idea that the country is such a healthful 
place to live in is good only so far as the 
country is fresh from the hand of the 
Lord, for Man's make-over in the country 
is generally poor — very poor. 

And now a word about the factory: we 
used to have an idea that the factory, 
often insanitary and un ventilated, was a 
big item in the problem of defective 
housing, simply because factory workers 
so often show the ill effects of bad hous- 
ing. The real fact seems to be that most 
of these workers live in very insanitary 
homes — badly housed and badly fed — in 
an environment tending to lack of sleep 
and rest, which often ends in dissipation: 
and that it is the home -life environment, 
and not the factory, which brings disaster 



50 Rural Housing 

to this class. In taking a census of cer- 
tain workers in a factory in a rural town, 
it was found that those whose home con- 
ditions and personal habits were good 
were just as healthy and successful as 
those who didn't work in the factory. 
The factory people, in this investigation, 
who were suffering from physical dete- 
rioration had invariably bad home con- 
ditions, or else bad personal habits. 



CHAPTER III 

DEFECTIVE BUILDING 

A great deal of the bad -housing con- 
ditions in the country is due to defective 
building. In the country an architect is 
rarely employed : the country carpenter, 
or a self-made contractor, does the work, 
neither of whom knows the first principle 
of construction: their sole object is to get 
the most building on the lot for the least 
money. Very often the owner himself 
plays the part of the architect, and then 
conditions, very often, are worse than 
otherwise. As a result of this state of 
affairs many country houses have gross 
sanitary defects, which could have been 

easily remedied by a little forethought. 

51 



52 Rural Housing 

As was mentioned several times before, 
one of the greatest defects in rural hous- 
ing is the "row," which of itself would not 
be bad — it isn't in the large, well-aired 
and roomy house of a great city — if the 
construction was properly made, but where 
window space is neglected or sacrificed 
and sunshine lessened, when ceilings are 
low, as they always are in such buildings, 
air-space is so curtailed that the building 
must contain, of necessity, serious faults; 
and when you find a room — a bedroom 
where there are no windows — you might 
almost believe you were transported to 
some of the places in New York which 
Mr. Riis tells about in his "Battle with 
the Slum." Yet such things are not 
mythical in the country: I can show you 
a windowless bedroom, and occupied too, 
in a certain house in a country town of 
less than 10,000 inhabitants. A good 
many of these bad conditions are brought 



Defective Building 55 

about by the remodeling of old buildings 
without the supervision of an architect. 
If ever an architect is needed, it is when 
an old building is made over — here, 
surely, expert advice is necessary. Of 
course, such serious defects are not so 
frequent, but they occur often enough to 
warrant the attention of those interested 
in improving housing conditions. 

Small windows and lack of windows 
are the great faults found in rural build- 
ing. In Fig. 10 is shown a house of this 
sort which might be considered a type of 
such conditions — isolated and open on 
all sides, it should be ideal for health, but 
the small windows give great lack of sun- 
shine and ventilation; one window, two 
by three feet, is the only opening on the 
entire side, and the other side, I am sorry 
to say, is just the same. It would be 
interesting to know what was passing 
through the mind of the builder who de- 



56 Rural Housing 

vised such a form of architecture, which 
certainly may help to account for the 
tuberculous history of this house, which is 
told in the last chapter. 

Another example of this defective build- 
ing characterized by small windows is 
shown in the photograph (Fig. 11): this 
probably was an old log-house, made over 
by weather-boarding and converting the 
original loft into an upper room. The log- 
cabin of the early settler, with its port- 
hole windows, was really not bad building 
in its day, for the inhabitants of those 
times led so much of an outdoor life and 
spent so little time indoors that what 
would be bad housing now to the clerk, 
the artisan, the mechanic, and the farmer 
had little effect on the frontiersman and 
the settler. 

The damp cellar is a very prominent 
defect in rural building: every one who 
lives or visits in the country knows the 



Defective Building 59 

damp, musty odor which pervades almost 
every country house, especially in the fall 
before the fires are started : so vastly dif- 
ferent is it from the dry atmosphere of 
the usual city house. This dampness is 
surely a potent factor in the cause of the 
various rheumatic complaints so common 
in most rural districts. It goes without 
saying that the proper construction of a 
building demands a dry cellar such as 
may be obtained by means of concrete and 
damp-proof course in the foundation. 

With the elimination of damp cellars, 
close building in rows, and small win- 
dows, much of the defect in rural housing 
would be overcome, and these corrections 
can usually be so readily accomplished 
that the only excuse for their existence is 
thoughtlessness or ignorance. It is hardly 
necessary to say that every house should 
have open space all around it, and be so 
situated that the greatest number or all 



60 Rural Housing 

of the rooms receive sunlight part of the 
day, as there is no disinfectant or de- 
oderant equal to sunlight: none so cheap 
and none to make up for its absence. This 
arrangement can very readily be made in 
the country on account of the abundance 
of room; indeed, the country is the ideal 
place for building, for one is not ham- 
pered by other dwellings nor excessively 
high cost, as is the case in most cities. 

In many places, as if to compromise 
with the "row," the buildings are put up 
double so as to house two families. While 
this is vastly better than row-building, it 
is not quite ideal; it approaches it and, in 
most instances, would be rightly classed as 
good building. In the accompanying pho- 
tograph (Fig. 12) is shown a picture of a 
street in a small town built more or less 
of isolated houses : plenty of windows and 
open space between each house give a 
vastly different appearance from the 



Defective Building 63 

street shown in Fig. 1, which was taken 
in another district of the same town. 

A point which is worth some thought is 
that dilapidation is not of necessity bad 
hygiene: the broken fence, the unhinged 
gate, the shattered window-pane, and the 
moss-covered roof look careless and are 
careless, but under cases of the greatest 
dilapidation I have seen splendid sanitary 
conditions. Some time ago, when inves- 
tigating a diphtheria outbreak in a moun- 
tain district, I visited a certain house 
where the disease was reported to exist. 
The dilapidation of the premises was 
striking, indeed — fences, doors, windows, 
porch, and everything else were broken 
and upside down. The health-officer in 
formed me that the family was large, and 
of course I expected to find conditions bad. 
When I entered the house I was surprised 
to find that almost every precaution 
known in the care of this disease was in 



64 Rural Housing 

force. The patient was isolated in an ad- 
joining room : she had her own dishes and 
toilet articles; the mother remained with 
her as nurse; the father did the cooking 
and caretaking of the rest of the family, 
and all absolutely remained out of the 
sick-room. When occasion required ad- 
mission to an upstairs room, instead of 
going through the sick-room the father 
climbed up a ladder on the outside; in 
addition, the sick child and all the rest of 
the family received antitoxin ; it is needless 
to state that there was only one case of 
diphtheria in that house. 

In an instance which came to my notice 
a few days ago, I found a case of typhoid 
fever in a lop-sided, broken-down log-cabin 
in a little mountain community: but here, 
as above, the dilapidation didn't count. 
The patient had a room to herself; her 
own dishes, and disinfectant solutions 
right beside the bed. As soon as the 



Defective Building 65 

physician had pronounced the disease to 
be typhoid, the family began using only 
boiled water for drinking, and disinfected 
all the discharges of the sick. The mother 
who attended her washed and disinfected 
her hands as carefully as any trained 
nurse: there were no secondary cases in 
that house. So much for general sanita- 
tion in dilapidated homes: when it comes 
to overcrowding, dilapidation in some of 
the houses we meet would be a boon, and 
really mean more air and sunshine, and 
consequently help to remedy the existing 
defect. However, we do not recommend 
dilapidation as the means to overcome 
sanitary errors. Dilapidation is unsightly 
and unpleasant, and may be nothing else, 
although the carelessness and shiftless- 
ness which breed it are very prone 
and very likely to breed real sanitary 
defects. 



CHAPTER IV 

OVERCROWDED AND DEFECTIVE 
SCHOOLS 

While the home life is vastly more im- 
portant than the school life, and though 
the sanitary arrangements of the sur- 
rounding farmhouses are usually vastly 
worse than the neighboring schools, yet 
it is quite likely that the country school — 
overcrowded and with glaring sanitary 
faults — is an item in the rural health. The 
little one-room schoolhouse (Fig. 13), so 
common all over the country, has turned 
out some great and good men, and women 
too, but it has also turned out many that 
might have gotten along better in the 
world if their physical condition and wel- 

66 



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Overcrowded and Defective Schools 69 

fare had been looked after: it is a good 
thing to remember that real progress is 
not the progress of the few great men, but 
the standard and average of the plain, 
ordinary citizen. 

Bad enough, indeed, is it when cities 
crowd their schools, but to have this con- 
dition, as is often the case, out in the 
country seems infinitely worse. The fact 
is that all city children, no matter what 
city or where, attend school under sani- 
tary conditions far ahead of anything in 
the country, for, like the rest of the rural 
community, the school has been sadly 
neglected, and the days when Ichabod 
Crane taught in Sleepy Hollow can al- 
most be duplicated in some of the back 
settlements. 

In many of these schools the most 
prominent fault is that of construction: 
that entailing in turn the various other 
abuses. With defective housing at home 



70 Rural Housing 

and defective conditions at school, is it 
any wonder that many country children 
fall far below the standard of physical 
excellence? Is it any wonder that medi- 
cal inspection of rural schools shows 
country children to be just as defective, 
in proportion, as city children? We used 
to think that the country was such a good 
place to raise children! But a change is 
taking place, even in the country. This 
very day I happened to visit a certain 
two-room country school (Fig. 14) planned 
and built by a trained architect — the first 
of its kind in one of the rural counties of 
Pennsylvania. The large, light, airy, and 
well-ventilated rooms are a pleasure to 
pupils, teacher, and patrons: a vast con- 
trast it is to the old-fashioned, dingy 
room of the past. Yet this township is no 
richer than any of its neighbors, but its 
school board is awake to the possibilities 
which come from advancing progress. 




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Overcrowded and Defective Schools 73 

The city school boards employ an archi- 
tect: why shouldn't we in the country? 
they reasoned. Nevermore in this sec- 
tion will the self-made contractor play 
the architect's part. 

It is generally conceded that a school 
building should have about twenty square 
feet of floor surface for each pupil, con- 
sequently it is easy to draw the line 
against overcrowding, by simply calcu- 
lating the number of pupils to be ad- 
mitted; but economic conditions change 
and a room built for thirty frequently con- 
tains fifty. The air-space per pupil should 
be between 250 and 500 cubic feet, de- 
pending on the means of ventilation: if 
there is no special arrangement for the 
admission of fresh air, the greater air- 
space — 500 cubic feet — will surely not be 
too much. In an ordinary country school 
— overcrowded, of course, — I have seen 
the air-space as small as 100 cubic feet 



74 Rural Housing 

per pupil, which is, without question, en- 
tirely too low. 

Now, as the air-space allowed each pupil 
depends on the ventilation, and as this 
depends on the heating in cold weather, 
ventilation and heating should be studied 
together. The ordinary country school 
will have to be heated for some time to 
come with a stove, which, while not ideal, 
is really not so bad if a jacketed stove is 
used and proper means of distributing the 
heat and admitting fresh air are arranged. 
In the usual stove-heated room, the floors 
are considerably colder — ten degrees, 
sometimes, — than the other parts of the 
room, and though the room may seem 
comfortable to the visitor, and proper ac- 
cording to a thermometer placed four or 
five feet above, yet the feet get consid- 
erably chilled in the lower temperature 
of the floor; and this unequal heating 
may perhaps help to account for the ca- 



Overcrowded and Defective Schools 75 

tarrhal troubles so common in country 
children. 

The space for admission of light should 
be about 20 per cent of the floor space, 
according to those who have studied this 
matter; yet in many, very many, of our 
country schools it is only 8 to 10 per cent. 
Imperfect lighting certainly leads to de- 
fective vision, of which there is a great 
deal in the country school; more to be 
deplored than in the city, as it is more 
difficult for the country pupil to get in 
touch with the trained oculist and have 
the visual error corrected than it is for 
the city child. 

In the construction should also be in- 
cluded the inadequate and insanitary 
toilet arrangements; and while they are 
usually as good, generally better, than 
the same appliances in the surrounding 
homes, yet they should be as perfect as 
our present knowledge will permit, not 



76 Rural Housing 

only for the sake of the health of the 
children, but as a matter of education to 
the coming generation. A good many 
people underestimate the value of such 
things, but children, with their receptive 
tendencies, will soon take note. Clean 
and bright-looking sanitary appliances, 
inducing personal cleanliness, will have a 
vast and enduring effect on the children, 
which will eventually affect their own 
homes and their whole life. I know of 
one instance in which a teacher's care to 
the sanitary details of the toilet so 
trained the children that not only did 
that school have the cleanest toilets in a 
whole county, but eventually the entire 
community felt the improvement, and the 
sanitary standard for the whole town was 
raised: of course, the result came slowly 
and gradually, but to this day that town 
owes much to the efforts of this one 
teacher. 



Overcrowded and Defective Schools 77 

It must be very apparent to any one 
that even with a modern school building 
much depends on the teacher, and the 
ignorance or indifference of teachers or 
directors will account for many sanitary 
oversights. The care of the toilets, as 
mentioned above, comes under this head. 
The lighting is another neglected item, 
for very often, even with ample window 
space, the light is much restricted by 
shades, many of which are out of order 
and impossible to roll up completely. 

The proper temperature of a room, as 
every one knows, or ought to know, can 
only be maintained with a thermometer, 
yet in the few schools having such an 
instrument how many teachers pay any 
attention to it or know its use? Once, at 
least, I remember, when a teacher asked 
me what the temperature of the room 
should be, she volunteered the informa- 
tion that " there was such a diversity of 



78 Rural Housing 

opinion among the directors"; and so it 
may have been. 

Much good may be done by the teacher 
in the way of habits of personal cleanli- 
ness. In our school inspections we notice 
very plainly that when the teacher is in 
sympathy with the work the improve- 
ment is far-reaching. Take, for example, 
the care of the teeth. Some of the large 
manufacturing chemists have made it a 
rule to send out to school-teachers sam- 
ples of dental paste or tooth-powder, 
for the use of their pupils, and a number 
of teachers with whom I am acquainted 
have obtained these samples and dis- 
tributed them among their pupils: the 
children are then encouraged to buy a 
tooth-brush and use it, and the result is 
an array of clean teeth and mouths that 
would have been a wonder a few years 
ago. And there are now tooth-brushes 
in Pennsylvania farmhouses, where the 



Overcrowded and Defective Schools 79 

parents never dreamed of such an article. 
This kind of work is worth encouraging, 
for the tooth-brush, like soap, is a sign 
of advancing civilization. No savage ever 
used a tooth-brush — nor soap, either. 



CHAPTER V 

RESULTS 

What is the result of this overcrowding 
and lack of proper housing in the country? 
Just exactly the same as in the great 
cities. Lack of efficiency, disease, and 
premature death to many. We have been 
talking much lately of our conservative 
policy of lumber, coal, and wild animals, 
but in many instances fail to see the great 
loss due to human inefficiency brought 
about by lack of suitable environment. 
While the great majority of people sub- 
jected to overcrowding and bad housing 
conditions do not prematurely die, yet 
they have a lessened physical and mental 

vigor, less able to do properly their daily 

80 



Results 8 1 

work, and not only become a loss to them- 
selves and their families, but to the State; 
and forever stand on the threshold of 
that dread disease — tuberculosis; for tu- 
berculosis is the one great disease of the 
overcrowded. 

Just how much tuberculosis we have 
in the rural districts in proportion to the 
great cities is pretty hard to say: but 
every one who has investigated it is posi- 
tive in the opinion that there is just as 
much in the country districts: indeed, 
some report more in the country than 
in the adjoining cities. We find it in 
the farmhouse and the mountain home: 
habits of carelessness possibly keep up 
the infection. We do not have "lung 
blocks," like the large cities, but we do 
have "lung houses" where case after case 
of tuberculosis has lived and perhaps de- 
veloped. Take, for example, the house 
shown in Fig. 10: situated far out in 



82 Rural Housing 

the country, and surrounded by as favor- 
able conditions as one could wish, yet 
look at its record in three different and 
unrelated families: — 
1 896-1 898. — M family: father died, 

mother sick of tuberculosis. 
1 898-1 900. — E family: father and 

one son died of tuberculosis. 
1 900-1 9 1 2. — L family: father and 

mother died of tuberculosis. 
Five deaths from tuberculosis in this 
one house — surely a record that carries 
some meaning with it ! 

Here is the story of a country "lung 
house," which, although its occupants be- 
longed to one family, and probably had 
that terrible hereditary tendency to the 
disease, they had such favorable environ- 
ment that improvement in the resisting 
powers of the various individuals should 
have developed, but voluntary bad living 
kept these people in about the same con- 



Results 85 

dition as if they had lived in one of the 
dark and windowless "lung blocks' ' of a 
great city, instead of in an isolated and 
inviting country house open on all sides 
to fresh air and sunshine. 

T family home (Fig. 15) 

1880-1901. — Inhabited by man, wife, and 

six children: 

Four died of tuberculosis. 
1902-1903. — Inhabited by man, wife, and 

eight children: 

Man and one child have tuberculosis. 
1904. — Inhabited by man, wife, and eight 

children : 

Four children have tuberculosis: three 
others are suspects. 
1905. — Inhabited by man, wife, and two 

children : 

Man died of tuberculosis. 
Eleven cases of tuberculosis in twenty- 
five years in this nice-looking farmhouse ! 



86 Rural Housing 

Fig. II shows a picture of a "lung 
house,' ' unique in covering a period of 
almost fifty years. This house is situated 
in a small town which has many things of 
historic interest, and this house, too, has 
a history, not of border warfare and heroic 
defence, but a story of sickness and death, 
perhaps a good deal of it avoidable. Six 
different families — not related, some black 
and some white, occupied this place dur- 
ing the last half -century: its record was 
such as to attract the attention of the 
neighbors, who were more prone to attrib- 
ute the fate of the inmates to witchcraft 
than to the deadly germ of tuberculosis. 

C Tuberculosis House 



1864. — James W (C. ) died of tu- 
berculosis. 

1870.— Miss A (W.) died of tu- 
berculosis. 



Results 87 

1 87 1. —Harry C (C. ) died of tu- 
berculosis. 

1872.— Miss H (W.) died of tu- 
berculosis. 

1880.— Mr. R (C. ) had tuber- 

culosis: moved away. 

1881.— Mr. W (W.) died of tu- 

berculosis. 

1900. — Mr. J (C. ) had tuber- 

culosis: moved away. 

1908. — Woods R (C. ) died of tu- 
berculosis at Mont Alto. 

1908. — Julia R (C. ) died of tu- 
berculosis. 

1912. — Mercedes H (C.) died of tu- 
berculosis. 
What a story! Ten sick of a lingering 

illness and eight deaths. And then the 

record is likely incomplete; probably the 

story is only "half told." 

The prevalence of tuberculosis in the 

country is so evidently marked that there 



88 Rural Housing 

is a growing interest in the subject in 
many places. The Wisconsin Antituber- 
culosis League, a year or so ago, made a 
very careful and exact sanitary survey of 
a certain rural district in that State, rel- 
ative to the amount of this disease, and 
found that in some parts of this district 
the death-rate from tuberculosis exceeded 
that of Milwaukee, Wisconsin's largest 
city. 

Minnesota also discovered that it had 
much tuberculosis in its rural districts. 
"As serious," says Dr. Daugherty, who 
investigated the subject, "as that in the 
congested areas of the cities." Following 
a rural survey of several townships, under 
the auspices of the State Antituberculosis 
Association, there were found housing 
conditions much as I have described in the 
preceding pages as existing in Pennsyl- 
vania. "The average number of people 
sleeping in one room," says the report, 



Results 89 

"was four." "In one house there were 
eight, in another nine, and it was not at 
all uncommon to find five or six. This 
was not due to the fact that there was not 
enough room, for in many of the houses 
the whole family would sleep in one room, 
use one for the kitchen, and leave two, 
three, and in some cases four, rooms 
vacant." 

Coincident with this bad housing there 
was found one township where there were 
twenty-two deaths from tuberculosis in a 
population of 500 in ten years: a death- 
rate of 44 per 10,000. These investiga- 
tors in Minnesota also found that "con- 
tributing causes, as overwork and poor 
food, which play such an important part 
among the inhabitants of the crowded 
tenement districts, do not usually count 
for much in the country. Bad housing 
and unrestricted exposure to contagion 
seem to be the great f actors.' ' Of course, 



go Rural Housing 

in certain well-to-do farming districts, 
such as were under investigation in Minne- 
sota, this would hold good, but in many 
other places, especially in parts of Penn- 
sylvania known to the author, poor food 
and lack of food are a vast contributing 
cause to this disease. A poor constitution 
to start with, and insufficient food, soon 
engender a condition which quickly yields 
to the inroads of the bacillus. As a corol- 
lary to this is the rapid improvement of 
such incipient cases, when put on the food 
and under the proper environment of a 
sanatorium. 

In illustration of this food question the 
following story is worth repeating. A 
visiting nurse was complaining to a 
mother that her little daughter, who was 
tuberculous, had not eaten any breakfast. 
The mother replied: "Well, it is her own 
fault. This morning we had prunes and 
bread and butter, and that is good enough 



Results 91 

for anybody.' ' She said this, too, as if 
some of her other breakfasts were not 
quite so good. This occurred, not in a 
city, but in a country town where living 
is comparatively cheap. The mother was 
poor, very poor, but she was grossly ig- 
norant, too, of foods and cooking. Had 
she given her child a bowl of mush and 
milk her intelligence would have con- 
quered her poverty. 

And now a word, a very short word, 
about the remedy for overcrowding and 
bad housing in the country. This prob- 
lem can not be attacked, as in the great 
cities, by legislative enactment or resort 
to legal measures, but the solution lies, 
it seems to me, in proper education by the 
various health authorities, by the schools, 
and by the press, and the crusade must be 
kept up until the people understand that 
it pays — pays in real dollars and cents — to 
live in sanitary homes. Educate the rural 



92 Rural Housing 

dweller in regard to the penalties for bad 
housing, show him how tuberculosis fol- 
lows in the wake of overcrowding, poor 

food, and dissipation: in a great many 

i 
instances he will mend his ways. In 

Pennsylvania this work is carried on by 
the Tuberculosis Dispensaries of the 
State Department of Health scattered all 
through the State, where they have be- 
come foci for spreading sanitary knowl- 
edge of just the sort needed in rural com- 
munities. Visiting nurses from these 
dispensaries go to the homes, and to my 
personal knowledge do much, very much, 
to remedy the defects of bad and improper 
living, and do it without resort to any 
legal means. There is no factor so potent 
for good as the work of the visiting 
nurses of this great health department; 
and many other States are taking up the 
work and carrying it forward on the same 
lines. 



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